Urinary Incontinence: Bladder Training
What is urinary incontinence?
Urinary incontinence means that you can't always control when you urinate. Causes of urinary incontinence include
weak pelvic muscles, certain medicines, build-up of stool in the bowels and medical problems such as diabetes or
congestive heart failure. About 12 million adults in the United States have urinary incontinence. It's most common in
women older than 50 years of age, but it can also affect younger people.
There are 4 main types of urinary incontinence:
Stress incontinence
Urge incontinence
Overflow incontinence
Functional incontinence
What is bladder training?
Bladder training is a behavioral technique used to treat people who have stress incontinence, urge incontinence or a
combination of the two (called mixed incontinence). Stress incontinence is when urine leaks because of sudden
pressure on your lower stomach muscles, such as when you cough, laugh, lift something or exercise. Urge
incontinence is when the need to urinate comes on so fast that you can't get to a toilet in time.
Your doctor will help you determine which type of incontinence you have and whether bladder training can help you.
How can bladder training help?
Bladder training can help in the following ways:
Lengthen the amount of time between bathroom trips.
Increase the amount of urine your bladder can hold.
Improve your control over the urge to urinate.
Where do I start?
Ask your doctor to help you develop a bladder training program. He or she may ask you to keep a bladder diary to
record how much and how often you urinate during a 24-hour period. This information will help your doctor create a
treatment program that's right for you.
During your bladder training program, your doctor may have you keep track of the number of urine leaks you have
each day. This will help you and your doctor determine whether bladder training is helping.
Listed below are examples of several different bladder training methods. Your doctor may recommend 1 or more of
these methods to help control your incontinence.
Kegel exercises: These are exercises that help strengthen the muscles you use to stop the flow of urine. More
information on Kegel exercises is available online at http://familydoctor.org/642.xml.
Delay urination: Some people who have urge incontinence can learn to put off urination after they feel the urge
to go. Start by trying to hold your urine for 5 minutes every time you feel an urge to urinate. When it's easy to
wait 5 minutes to urinate, try to increase the waiting period to 10 minutes. Gradually lengthen the waiting
period until you're urinating every 3 to 4 hours.
When you feel the urge to urinate before your time is up, it may be helpful for you to practice relaxation
techniques. Breathe slowly and deeply. Concentrate on your breathing until the urge goes away. Doing Kegel
exercises may also help you control urges.
Scheduled bathroom trips: Some people control their incontinence by going to the bathroom on a schedule.
This means that you plan times to go to the bathroom, whether you feel the urge to urinate or not. For
example, you might start by going to the bathroom every hour. Then gradually increase the time between
bathroom trips by 30 minutes until you find a schedule that works for you.
Remember, bladder training often takes 3 to 12 weeks. Don't be discouraged if you don't have immediate results or if
you still experience some incontinence.
What else can I do?
You may find it helpful to change your diet. Alcohol, caffeine, foods high in acid (such as tomato or grapefruit), and
spicy foods can irritate your bladder. Talk to your doctor if you think your diet may contribute to your incontinence.
Some people find that limiting how much they drink before bedtime helps reduce nighttime incontinence.
Losing weight if you are overweight can also help reduce incontinence.
Are there other ways to treat incontinence?
Yes. Medicines or medical devices can treat some types of urinary incontinence. In some cases, surgery may be an
option. Treatment depends on what type of urinary incontinence you have and what is causing the problem.
Other Organizations
National Association for Continence
P.O. Box 1019
Charleston, SC 29402 -1019
800-BLADDER (252-3337)
American Foundation for Urologic Disease
1000 Corporate Blvd, Suite 410
Linthicum, MD 21090